Date: 09/10/2007

Final
A Plan for Covering Colorado

HEALTH CARE TASK FORCE

Votes: View--> Action Taken:
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11:00 AM -- Bruce Cooper, A Plan for Covering Colorado

Bruce Cooper provided the committee with a handout of his powerpoint presentation of the plan for covering all Coloradans (Attachment E). He stated that he represents an ad hoc committee which is comprised of doctors and nurses that do not have any affiliation with any particular group. Dr. Cooper stated that health care is a right versus a privilege and that basic health care coverage should be offered. Dr. Cooper stated that their plan incorporates combining public and private health care systems, and provided a brief overview of the key elements of the proposal which include:
  • expanding Medicaid and the Children's Basic Health Care Plan (CHP+), and ultimately combining and simplifying the two;
  • reforming private health insurance by creating a single market pool;
  • providing premium assistance to low-income families; and
  • establishing an oversight board insulated from political and special interest groups to administer the pool.

    Dr. Cooper stated that the proposal calls for shared responsibility between individuals and families concerning financing. Dr. Cooper provided details about expanding Medicaid and CHP+. He stated that their proposal does not get rid of the private insurance system because people are familiar with it and it will maintain competition within the system and keep costs down. Dr. Cooper stated you cannot enhance competition based on consumer choice. Dr. Cooper stated that their proposal avoids underinsurance while providing comprehensive coverage.

    11:11 AM

    Dr. Cooper stated that the proposal calls for creating a single market (purchasing pool) for all private health insurance. He stated that the single market would combine large business, small business, individuals, and CoverColorado into a single pool. He stated that all plans offered cover essential services, but a limited number of packages offered will be directed toward low-income individuals. Dr. Cooper stated that the second aspect of reforming the private insurance system will be to provide a subsidy for low and lower-middle income families and individual (families currently below 200 percent of the federal poverty level will be increased to 400 percent of the federal poverty level). He stated that recipients of the low-income plans will be have a choice between two different plans.

    11:15 AM

    Dr. Cooper explained that the Colorado Health Insurance Purchasing Authority was modeled off the Federal Reserve Board. He stated that the authority will define and update the minimum benefit package (plan offered to low-income individuals), approve the standard benefit packages, update the affordability standards, and set requirements for plans that issue subsidized packages. He stated that the standard benefit package would include prescription drug coverage, mental illness treatment, substance abuse treatment, oral, vision, and hearing coverage, and chronic disease management. Dr. Cooper stated that individuals or families have the option to buy "add ons" for each plan if they choose. He stated the medical home model, health information technology, and a 1-800 number for information are also included in the reform proposal. A medical home is a qualified medical specialty, developmental, therapeutic, or mental health care practice that ensures access to and coordination of all medically-related services. Some of the services provided are health maintenance and preventative care, health education, acute and chronic illness care. coordination of medications, specialists, and therapies, provider participation in hospital care, and a 24-hour telephone care line.

    11:18 AM

    Dr. Cooper stated that everyone in the state of Colorado would be responsible for financing the proposal. He stated the plan:
    Dr. Cooper stated that the proposal will cover approximately 87 percent of Coloradans. He stated that it will increase spending by 1.3 billion and that cost savings come from overhead reduction, case management, and the use of the medical home model.

    11:25 AM

    Representative Massey asked about the authority and who would be appointed. Dr. Cooper stated that the authority would be like what Dr. White described in his plan. Representative Massey asked what a medical home costs or saves the state as a primary care provider. Dr. Cooper stated that the Lewin Group provided the number of 66 percent increase in utilization. He stated that he believes there will be cost savings when that population is moved from using emergency rooms versus medical homes to provide primary care. Representative Swalm asked about the Massachusetts plan where an employer pays a penalty of about $250, while this plan calls for a $347 penalty. Representative Swalm stated that some employers pay that much a month right now, so where is incentive. Dr. Cooper stated that some employers offer insurance as a competitive job package. Representative Swalm stated he was concerned about a pure community rating, and asked about the rationale for this in the plan. Dr. Cooper stated they selected the pure community rating primarily because of society's duty to provide health care. He stated that the current system discriminates against low-income individuals who may be older but who also have the greatest need.